Category Archives: Customvue

PRK (photorefractive keratectomy) was the first laser vision correction used to eliminate glasses and contact lenses. The first PRK was done in North America in the 1980’s and PRK has remained an excellent way to eliminate nearsightedness, farsightedness, and astigmatism.

PRK involves removing just the surface layer of cells on the surface of the cornea (the clear winshield-like structure on the front of the eye) and then reshaping the surface using the excimer laser. A contact lens is placed on the surface for three to five days as the surface cells grow back to cover the cornea. Most people are back to usual activities in 7 to 10 days.

LASIK (laser in situ keratomileusis) was developed in the 1990’s as a way to speed up the recovery from laser vision correction. Also called “Flap & Zap”, LASIK involves cutting a flap from the cornea, folding it back out of the way to reshape the surface underneath with the excimer laser, and then replacing the flap to it’s original position. This allows people to be back to usual activities within a day or two but does carry higher risks; the LASIK flap is more complicated to create, the flap can be shifted even months or weeks later, and the cornea is weakened more from the LASIK flap.

For over twenty-five years surgeons have preferred to use PRK for people with thin corneas or other factors that may make LASIK too risky. With the newer excimer lasers a customized wavefront laser pattern can be used. This custom wavefront treatment uses a map of the patients vision system to create an individualized laser treatment pattern – much like a fingerprint that is customized to each individual eye. Some surgeons believe that a customized treatment is more effective with PRK because the LASIK flap will cover up the finely customized wavefront treatment.

Many surgeons around the world are choosing PRK as their preferred way to do laser vision correction due to the excellent results and safety. Although the risks are low with LASIK, they are lower with PRK and most complications of PRK are easier to treat than a complicated LASIK flap.

For people who are looking for safe and effective laser vision correction the combination of PRK/Advanced Surface Ablation with customized wavefront laser treatment is an excellent choice.

If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

Dr. M. Purba brings years of optometry experience in the field of pre & post PRK and LASIK care as well as extensive experience in optometric eye health care to the practice. She will be available to do general eye exams, prescribe glasses, and provide specialized treatment for conditions such as dry eye, blepharitis, and glaucoma.

Optometrists specialize in the treatment of many eye problems. They are complimentary to ophthalmologists who are Eye MD’s and often work together with ophthalmologists to co-manage patients.

There are a number of things to consider when deciding whether or not to have laser vision correction and where to have it done.

It can be helpful to have more than one refractive assessment to meet staff, see the facility, and learn about the services offered at that center. Most importantly a thorough refractive assessment will determine if laser vision correction is safe for you. There are many factors that are considered during an assessment including corneal thickness, corneal shape, how high your correction is, and general medical and eye health issues. More information about these factors can be found in Dr. Anderson Penno’s book Laser Vision Correction: What You Need To Know available at: http://www.amazon.com/Laser-Vision-Correction-What-Need/dp/143926497X/ref=sr_1_4?s=books&ie=UTF8&qid=1296107050&sr=1-4

It is important to choose a surgeon you are comfortable with and a procedure that is right for you. When choosing a procedure the laser vision correction options fall into flap and no-flap categories. Flap procedures include Intra-LASIK (called I-LASIKby AMO) and LASIK. These treatments both involve the creation of a corneal flap and carry a higher risk than surface treatments. No-flap surface treatments include PRK, Epi-LASIK, and LASEK. For surface treatments the epithelium layer is removed and the laser is applied to the surface of the cornea. Many refractive surgeons believe that a wavefront treatment will be most effective if used in combination with a surface laser vision correction rather than a flap treatment. The reason is that the corneal flap created by LASIK or Intra-LASIK may induce additional vision abberations that may diminish the benefit of a wavefront treatment.

Wavefront laser vision correction involves measuring the higher order aberrations that are individual to each eye and then using that data to create an individualized laser vision correction. The analogy that is often used is that for nearsighted eyes the cornea is shaped like a basketball that is too steep, for farsighted eyes the basketball is too flat, and in astigmatism the cornea is shaped like a football. A standard laser vision correction will reshape the cornea into a sphere (basketball) that is just right. Wavefront treatments will then smooth out any imperfections that may be present on the surface to produce maximum vision results.

There are many studies that indicate the benefits of wavefront treatment in maximizing uncorrected vision. Due to the number of different laser manufacturers, variety of treatments (flap, no-flap, etc.), surgeon differences, and individual healing responses it is difficult to make an exact quantification of the benefits of wavefront treatments compared to standard laser ablation or between wavefront capable lasers. Reliable scientific studies can be found in peer reviewed studies such as those available at the US National Library of Science online database:http://www.ncbi.nlm.nih.gov/pubmed TheVISX S4 IR Customvue system is the most widely used custom wavefront system used in North America. It has benefits of iris recognition and cyclotorsion (rotational) adjustment that enhances accuracy. It also features a variable repetition rate and variable spot size which reduces heat generation and allows for a very refined corneal reshaping capability.

Wavefront custom laser vision correction can enhance visual results and is one of the factors that should be considered when deciding whether to have laser vision correction and where to have it. For more information or to book a refractive consultation with Dr. Anderson Penno, contact Western Laser Eye Associates.